Prevalence and associated factors with presumptive tuberculosis in the war-torn Tigray, Ethiopia: a community-based comparative study.

PURPOSE: Presumptive tuberculosis refers to individuals who presents with symptoms or signs of suggestive active TB having at least one of these clinical manifestations (more than two weeks of, cough, fever, appetite loss, night sweating, chest pain, or weight loss). Although tuberculosis is both preventable and curable, it continues to cause millions of new infections and fatalities globally. With a national burden that ranks third in Africa and eighth globally, Ethiopia remains a high-burden country for tuberculosis. Tigray had 6700 confirmed tuberculosis cases in 2020, immediately before the war had started. War is an ideal condition for the spread of TB. This has happened in Tigray following the war. Therefore, this study aimed to assess a community-based presumptive tuberculosis among rural and urban residents after the conflict in Tigray region of Ethiopia.

METHODS

A community-based comparative cross-sectional study design was conducted from January to February 2024 for a total of 2340 participants selected using the multistage cluster sample technique. The data was collected using an open data kit and then exported to SPSS version 23 for analysis. Logistic regression, both bivariate and multivariable analysis, was used to see the association between independent and dependent variables.

FINDINGS: The overall prevalence of presumptive tuberculosis was found 10.6% (95% CI: 8.4%,13%), with a slight difference burden between the rural and urban, 12.3% (95% CI, 10.8%, 14%) and 11.8% (10.6%, 13.1%), respectively. Different factors, like inadequate ventilation, sleeping with hunger, close contact with known TB patients, and households unvisited by health extension workers were significantly associated with presumptive tuberculosis.

CONCLUSION

Given the conflict and the region's destroyed medical infrastructure, this finding might help in identifying those who likely have active tuberculosis. Therefore, improving access to TB screening and diagnostic services closer to the communities throughout the region is critically important during post-war to address the burden of tuberculosis.